BACKGROUND Overweight children exhibit a higher prevalence of functional gastrointestinal disorders compared with their normal-weight peers,yet the underlying reasons remain unclear.Gastrointestinal motility,a key pat...BACKGROUND Overweight children exhibit a higher prevalence of functional gastrointestinal disorders compared with their normal-weight peers,yet the underlying reasons remain unclear.Gastrointestinal motility,a key pathophysiological factor in functional gastrointestinal disorders,may be influenced by body mass index(BMI).AIM To evaluate the impact of BMI on gastric motility parameters in children with functional abdominal pain disorders(FAPDs).METHODS We assessed gastric motility in 176 children with FAPDs(61.4%females,mean age 7.94 years,SD 1.96 years)and 63 healthy controls(57.1%females,mean age 9.17 years,SD 1.90 years)at the Gastroenterology Research Laboratory,University of Kelaniya,Sri Lanka.FAPDs were diagnosed and subtyped using the Rome IV criteria:Functional abdominal pain 97 patients;irritable bowel syndrome 39 patients,functional dyspepsia(FD)25 patients;and abdominal migraine 15 patients.Gastric motility was measured using a validated ultrasound method.Weight and height were measured using sensitive standard scales.RESULTS The BMIs of children with FAPDs and controls were 15.04 and 15.46 kg/m^(2),respectively(P=0.33).Fasting antral area(FAA)and antral area at 1 min(AA1)and 15 min(AA15)were significantly greater in patients with FAPD with a higher BMI(2.71 cm^(2),12.57 cm^(2),and 7.19 cm^(2),respectively)compared with those with a lower BMI(2.12 cm^(2),10.68 cm^(2),and 6.13 cm^(2),respectively)(P<0.01).BMI positively correlated with FAA and AA15(r=0.18 and r=0.19,respectively)(P<0.01)in those with FAPDs.In controls,only AA1 was greater in the higher BMI group(12.51 cm^(2)vs 9.93 cm^(2))and had a positive correlation(r=0.33)(P≤0.01).Subgroup analysis revealed that in patients with FD,BMI negatively correlated with gastric emptying rate(GER)(r=-0.59)and antral motility index(MI)(r=-0.49),while in functional abdominal pain,MI positively correlated(r=0.25)with BMI(P≤0.01).CONCLUSION In children with FAPDs,higher BMI was associated with increased gastric antral distention during fasting and postprandial periods(as indicated by FAA,AA1,and AA15)but not with contractility and transit(MI,GER).However,in the FD subgroup,high BMI correlated with reduced GER and MI.This indicates the possible role of BMI in gastric hypomotility and the pathophysiology of FD.These findings underscore the importance of lifestyle and dietary interventions aimed at optimizing BMI in the management of FAPDs,particularly FD.展开更多
Objective To explore the clinical effects of heat-sensitizing moxibustion on functional anorectal pain. Methods Thirty six patients with functional anorectal pain were treated with moxibustion on heat-sensitive acupun...Objective To explore the clinical effects of heat-sensitizing moxibustion on functional anorectal pain. Methods Thirty six patients with functional anorectal pain were treated with moxibustion on heat-sensitive acupuncture points.The heat-sensitized points include Chángqiáng（长强 GV l）, Cìliáo（次髎 BL 32）, Yāoshū（腰俞 GV 2）, and local perianal points. A course of treatment consisted of treatment at each heat-sensitized point for 15 min once per day for 10 days. The therapeutic effects were observed after continuous treatment for 3 treatment cycles. Results Twelve cases were cured, eleven cases had effective results, and 3 cases were ineffective. The total effectiveness rate was 91.7%. The visual analog scale（VAS） total score was 6.1±1.52 before treatment and was 1.63±1.05 after treatment, showing a statistically significant difference（P〈0.01）. Conclusion Heat-sensitization moxibustion can significantly relieve functional anorectal pain.展开更多
Objective:To investigate the clinical effect of electroacupuncture combined with biofeedback on functional anorectal pain.Methods:Sixty patients diagnosed functional anorectal pain were divided into three groups by ra...Objective:To investigate the clinical effect of electroacupuncture combined with biofeedback on functional anorectal pain.Methods:Sixty patients diagnosed functional anorectal pain were divided into three groups by random number table,namely electroacupuncture group,biofeedback group,and combination group,with 20 patients in each.In the electroacupuncture group,the electroacupuncture at Dong’s points Sānqí(三其穴),including Qímén(其门),Qíjiǎo(其角),and Qízhéng(其正),and Línggǔ(灵骨),Dàbái(大白),Chángmén(肠门)of both sides was given;in the Biofeedback group,the biofeedback therapy was adopted;in the combination group,the electroacupuncture and biofeedback therapy were used.All patients were treated once a day,30 min each time,10 consecutive treatments as one treatment course,and the therapeutic effect was evaluated after 3 treatment courses.The observation indexes after the intervention:Visual analogue Scale(VAS)score,SF-36 Quality of Life Scale score,Self-rating Anxiety Scale(SAS)score,Self-rating Depression Scale(SDS)score,Anorectal manometry,Clinical efficacy,and patients’adverse reactions.Results:After treatment,the pain of patients in the three groups was alleviated than that before treatment,VAS score,SAS score,SDS score,and anorectal pressure were decreased(P<0.05),and SF-36 Quality of Life Scale score was increased(P<0.05).After treatment,in the combination group,the VAS scores,SAS scores,SDS scores,and Anal-rectal pressure scores were lower than those in the other two groups(P<0.05),and SF-36 Quality of Life Scale scores were higher than those in the other two groups(P<0.05),the total effective rate was 80.0%(16/20),which was significantly higher than that of the electroacupuncture group(55.0%,11/20)and the biofeedback group(40.0%,8/20)(both P<0.05).No adverse reactions occurred in all three groups.Conclusion:Electroacupuncture at Dong’s points combined with biofeedback therapy has a significant effect on functional anorectal pain.The combined application of electroacupuncture and biofeedback therapy has a synergic action,and the analgesic effect is better than that of only using electroacupuncture or biofeedback therapy.展开更多
Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodont...Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodontic treatment. Forty individuals(12–33 years old; mean ± standard deviations: 20.8 ± 5.9 years) scheduled to receive orthodontic treatment were randomly divided into a laser group(LG) or a placebo group(PG)(1:1). The LG received LLLT(810-nm gallium-aluminium-arsenic diode laser in continuous mode with the power set at 400 mW, 2 J·cm–2) at 0 h, 2 h, 24 h, 4 d, and 7 d after treatment, and the PG received inactive treatment at the same time points. In both groups, the non-treated side served as a control. A numerical rating scale(NRS) of pain, pressure pain thresholds(PPTs), cold detection thresholds(CDTs), warmth detection thresholds(WDTs), cold pain thresholds(CPTs), and heat pain thresholds(HPTs) were tested on both sides at the gingiva and canine tooth and on the hand. The data were analysed by a repeated measures analysis of variance(ANOVA). The NRS pain scores were significantly lower in the LG group(P = 0.01). The CDTs,CPTs, WDTs, HPTs, and PPTs at the gingiva and the PPTs at the canine tooth were significantly less sensitive on the treatment side of the LG compared with that of the PG(P < 0.033). The parameters tested also showed significantly less sensitivity on the nontreatment side of the LG compared to that of the PG(P < 0.043). There were no differences between the groups for any quantitative sensory testing(QST) measures of the hand. The application of LLLT appears to reduce the pain and sensitivity of the tooth and gingiva associated with orthodontic treatment and may have contralateral effects within the trigeminal system but no generalized QST effects. Thus, the present study indicated a significant analgesia effect of LLLT application during orthodontic treatment.Further clinical applications are suggested.展开更多
BACKGROUND Abdominal pain-predominant functional gastrointestinal disorders(AP-FGIDs)are the most common cause of recurrent abdominal pain in children. Despite its high prevalence, the underlying pathophysiology of th...BACKGROUND Abdominal pain-predominant functional gastrointestinal disorders(AP-FGIDs)are the most common cause of recurrent abdominal pain in children. Despite its high prevalence, the underlying pathophysiology of this condition is poorly understood.AIM To assess the role of gastric dysmotility and autonomic nervous system dysfunction in the pathophysiology of AP-FGIDs.METHODS One hundred children, fulfilling Rome III criteria for AP-FGIDs, and 50 healthy controls, aged 5 to 12 years, were recruited after obtaining parental consent. All patients were investigated for underlying organic disorders. Gastric motility and cardiovascular autonomic functions were assessed using validated non-invasive techniques.RESULTS The main gastric motility parameters assessed(gastric emptying rate [45.7 vs 59.6 in controls], amplitude [48.7 vs 58.2], frequency of antral contractions [8.3 vs 9.4],and antral motility index [4.1 vs 6.4]) were significantly lower in children with AP-FGIDs(P < 0.05). The post-prandial antral dilatation at 1 min after the test meal significantly correlated with the severity of abdominal pain(P < 0.05).Assessment of autonomic functions in AP-FGID patients showed neither a significant difference compared to the control group, nor a correlation with gastric motility abnormalities(P > 0.05). The duration of pain episodes negatively correlated with the parasympathetic tone(maladaptive parasympathetic tone)(P< 0.05).CONCLUSION Children with AP-FGIDs have abnormal gastric motility but normal cardiovascular autonomic functions. There is no relationship between abnormal gastric motility and autonomic functions. The pathogenesis of AP-FGIDs is not related to cardiovascular autonomic dysfunction.展开更多
AIM:To assess the efficacy of glucomannan(GNN) as the sole treatment for abdominal pain-related functional gastrointestinal disorders(FGIDs).METHODS:We conducted a double-blind,placebocontrolled,randomized trial.Patie...AIM:To assess the efficacy of glucomannan(GNN) as the sole treatment for abdominal pain-related functional gastrointestinal disorders(FGIDs).METHODS:We conducted a double-blind,placebocontrolled,randomized trial.Patients were recruited among children referred to the Department of Paediatrics,Medical University of Warsaw.Included in the study were children aged 7-17 years with abdominal pain-related FGIDs classified according to the Rome Ⅲ diagnostic criteria.The children were randomly assigned to receive GNN,a polysaccharide of 1,4-D-glucose and D-mannose,a soluble fiber from the Japanese Konjac plant,at a dosage of 2.52 g/d(1 sachet of 1.26 g 2 times a day),or a comparable placebo(maltodextrin) at the same dosage.The content of each sachet was dissolved in approximately 125 mL of fluid and was consumed twice daily for 4 wk.RESULTS:Of the 89 eligible children,84(94%) completed the study."No pain" and "treatment success"(defined as no pain or a decrease ≥ 2/6 points on the FACES Pain Scale Revised) were similar in the GNN(n = 41) and placebo(n = 43) groups [no pain(12/41 vs 6/43,respectively;RR = 2.1,95%CI:0.87-5.07) as well as treatment success(23/41 vs 20/43;RR = 1.2,95%CI:0.79-1.83)].No significant differences between the groups were observed in the secondary outcomes,such as abdominal cramps,abdominal bloating/gassiness,episodes of nausea or vomiting,or a changed in stool consistency.GNN demonstrated no significant influence on the number of children requiring rescue therapy,school absenteeism,or daily activities.CONCLUSION:In our setting,GNN,as dosed in this study,was no more effective than the placebo in achieving therapeutic success in the management of FGIDs in children.展开更多
This paper reviews empirical work on cognitive and social learning contributions to the etiology and treatment of illness behavior associated with functional abdominal pain and inflammatory bowel disease. A particular...This paper reviews empirical work on cognitive and social learning contributions to the etiology and treatment of illness behavior associated with functional abdominal pain and inflammatory bowel disease. A particular emphasis is placed on randomized controlled trials, the majority of which are multi-modal in orientation, incorporating elements of cognitive behavioral therapy, social learning, and relaxation. Based on this review, we offer methodological and clinical suggestions: (1) Research investigations should include adequate sample sizes, long-term follow-up assessments, and a credible, active control group. (2) Standard gastrointestinal practice should include, when appropriate, learning opportunities for patients and family members, for example, instruction regarding the encouragement of wellness behavior.展开更多
Background: The aim of this study was to assess the effects of functional training (FT) on pain, function, and performance in elite male taekwondo players with CMLBP. Method: 27 elite male taekwondo players (mean ...Background: The aim of this study was to assess the effects of functional training (FT) on pain, function, and performance in elite male taekwondo players with CMLBP. Method: 27 elite male taekwondo players (mean ± standard deviation: age 24.4 ± 4.9 years, body mass 75.7 ± 15.1 kg, height 181.4 ± 7.8 cm) were allocated to two experimental (n = 15) and control (n = 12) groups. The eight-week FT was divided into four distinct phases for the subjects of the experimental group. Variables of pain and function were assessed by Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), respectively. The movement time of Ap Douliou Chagi kick (MTAK) and speed of Ap Douliou Chagi kick (SAK) was used for the variable of performance. Results: Considering the results of pretest before the implementation of the scores protocol, after FT intervention, VAS (p = 0.004), ODI (p = 0.005), MTAK on the right leg (p = 0.029) and the left leg (p = 0.013) decreased and SAK on both legs (p = 0.000) increased significantly in comparison with the control group. Conclusion: It is assumed that FT can reduce the pain intensity and improve the function and performance in taekwondo players.展开更多
Functional abdominal pain disorders(FAPDs) are an important and prevalent cause of functional gastrointestinal disorders among children, encompassing the diagnoses of functional dyspepsia, irritable bowel syndrome, ab...Functional abdominal pain disorders(FAPDs) are an important and prevalent cause of functional gastrointestinal disorders among children, encompassing the diagnoses of functional dyspepsia, irritable bowel syndrome, abdominal migraine, and the one not previously present in Rome Ⅲ, functional abdominal pain not otherwise specified. In the absence of sufficiently effective and safe pharmacological treatments for this public problem, non-pharmacological therapies emerge as a viable means of treating these patients, avoiding not only possible side effects, but also unnecessary prescription, since many of the pharmacological treatments prescribed do not have good efficacy when compared to placebo. Thus, the present study provides a review of current and relevant evidence on non-pharmacological management of FAPDs, covering the most commonly indicated treatments, from cognitive behavioral therapy to meditation, acupuncture, yoga, massage, spinal manipulation, moxibustion, and physical activities. In addition, this article also analyzes the quality of publications in the area, assessing whether it is possible to state if non-pharmacological therapies are viable, safe, and sufficiently well-based for an appropriate and effective prescription of these treatments. Finally, it is possible to observe an increase not only in the number of publications on the non-pharmacological treatments for FAPDs in recent years, but also an increase in the quality of these publications. Finally, the sample selection of satisfactory age groups in these studies enables the formulation of specific guidelines for this age group, thus avoiding the need for adaptation of prescriptions initially made for adults, but for children use.展开更多
Objective： To observe the clinical efficacy of oral traditional Chinese medicine （Jiaweitiaoqi decoction）, electroacupuncture, biofeedback, and combined treatment on functional anorectal pain （FAP）. Methods： A ...Objective： To observe the clinical efficacy of oral traditional Chinese medicine （Jiaweitiaoqi decoction）, electroacupuncture, biofeedback, and combined treatment on functional anorectal pain （FAP）. Methods： A total of 200 patients with FAP were randomly divided into 4 groups, with 50 patients in each group. Group 1 was given oral Jiaweitiaoqi decoction; group 2 was given electroacupuncture at the lumbosacral acupoints; group 3 was given biofeedback training; and group 4 was given combined treatment. The numeric rating scale （NRS）, Short Form-36 （SF-36） quality of life scale, static pressure of the anal canal, and maximum systolic pressure were observed in the 4 groups. Results： The observation indices of the 4 groups were all improved after treatment compared with those before treatment, and the fourth group showed the most obvious improvement. Regarding NRS scores, the static pressure of the anal canal, and maximum systolic pressure, group 4 had lower values than the other 3 groups （P 〈 0.05 for all）. In the SF-36 quality of life score, group 4 showed a higher value than the other 3 groups （P 〈 0.05）. Conclusion： Non-drug therapy including acupuncture and physical exercise can enhance the clinical efficacy of single Chinese medicine in the treatment of FAP .展开更多
AIM: To validate the culturally-adapted Persian Functional Rating Index(PFRI) for assessing neck pain(NP) in athletes. METHODS: In this cross-sectional study, 100 athletes with NP and 50 healthy athletes participated ...AIM: To validate the culturally-adapted Persian Functional Rating Index(PFRI) for assessing neck pain(NP) in athletes. METHODS: In this cross-sectional study, 100 athletes with NP and 50 healthy athletes participated and responded to the PFRI. Fifty athletes with NP completed the PFRI for at least 7 d later to establish test-retest reliability. RESULTS: The athletes with NP responded to all items, indicating excellent clinical utility. No floor and ceiling effects were found, indicating content validity and responsiveness. The PFRI revealed capability to discriminate between the athletes with NP and healthy athletes. The PFRI demonstrated strong correlation with the Numerical Rating Scale(Spearman's rho = 0.94), and the Persian Neck Disability Index(Pearson r = 0.995), supporting criterion and construct validity. Internal consistency reliability was high(Cronbach's α coefficient: 0.97). The test-retest reliability was excellent(ICCagreement = 0.96). The absolute reliability values of standard error of measurement and smallest detectable change were 3.2 and 8.84, respectively. An exploratory factor analysis yielded one factor explaining 78.03% of the total variance. CONCLUSION: The PFRI is a valid and reliable measure of functional status in athletes with NP.展开更多
AIM: To study the changes of the resting state functional connectivity(rsFC) between acute eye pain(EP) subjects and healthy controls(HCs) in the two hemispheres by using voxel-mirrored homotopic connectivity(VMHC) me...AIM: To study the changes of the resting state functional connectivity(rsFC) between acute eye pain(EP) subjects and healthy controls(HCs) in the two hemispheres by using voxel-mirrored homotopic connectivity(VMHC) method.METHODS: Totally 20 patients with EP and 20 HCs were enrolled, sex, age, and education were matched, and all subjects were examined by functional magnetic resonance imaging(fMRI) scans at resting-state. The changes of rs FC between the hemispheres were evaluated by the VMHC method according to Gaussian random field(GRF) theory. In order to identify the VMHC, as biomarkers for distinguishing EP and from HC, the receiver operating characteristic curves(ROC) had been analyzed. The relationships were evaluated with Pearson correlation analysis between the mean VMHC signal values and clinical features in these patients.RESULTS: By comparing with health subjects, the significant decreased VMHC values was observed in lingual/calcarine(Brodmann area, BA 30), precentral/postcentral gyrus(PreCG/PosCG; BA 4) and medial frontal gyrus(MFG; BA 8)(false discovery rate corrected <0.01) in the acute EP individuals. The accuracy of area under curve was excellent indicated by the ROC curve analysis of each brain regions.CONCLUSION: Our study demonstrates preliminary evidence of disrupted interhemispheric rsFC in acute EP in sensorimotor and limbic system and somatosensory cortex, which might give some useful information for understanding the neurological mechanisms in acute EP individuals.展开更多
Functional pain syndromes are very common diseases that negatively impact the quality of life of patients with important socio-economic repercussions. The clinical alterations associated with these pathologies are mul...Functional pain syndromes are very common diseases that negatively impact the quality of life of patients with important socio-economic repercussions. The clinical alterations associated with these pathologies are multiple and have a complex psycho-organic character that moves along the micorobiome-gut-brain-axis. For the present study, 45 patients of both sexes (19 male, 26 female) aged 30 - 59 years were enrolled because of a diagnosis of Functional pain syndromes (FPS) that lasted for more than 6 months. All patients underwent pre-treatment clinical assessments (T0) for anxiety disorder, multidimensional assessment of pain, monitoring of baseline values of Alpha-Theta cerebral rhythm in occipital region and monitoring of salivary cortisol levels. All the patients underwent a clinical treatment combined with central neuromodulation with neurofeedback—Alpha Theta increase protocols (once a week for three months), administration of multispecies probiotic (one dose per day for 3 months) and clinical psychological interviews (once a week for three months). At the end of treatment (T1), patients were re-evaluated. Results show statistically relevant improvements of each feature considered: the Relief from Pain provided by the medication increases on average from 36.6% to 87.3%, the salivary Cortisol level at 11 pm decreases from 6.4 ng/ml to a physiological value of 1.2 ng/ml, and the anxiety rating score is reduced from 28 to 12. Moreover, the 23.9% increase in α-θ relative power shows the positive outcome of the brain autoregulation. This study highlights that the combined approach of Neurofeedback with drugs and multispecies probiotic results in great improvements in the patients’ life.展开更多
Objective:Network pharmacology method was adopted in this study to screen the target of Zhitong Rushen Decoction of the treatment to Functional Anorectal Pain(FAP)and explore its mechanism of treatment.Methods:Chemica...Objective:Network pharmacology method was adopted in this study to screen the target of Zhitong Rushen Decoction of the treatment to Functional Anorectal Pain(FAP)and explore its mechanism of treatment.Methods:Chemical components and selected targets related to the ten traditional Chinese medicine(TCM)herbs were searched through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).Through GeneCards database,OMIM database,disease targets of FAP were searched.R language was used to screen the common targets between drugs and disease,and then the interaction network diagram of the targets was constructed by String.Cytoscape3.7.0 was applied to construct the active ingredients-targets interacted network.GO enrichment analysis and KEGG enrichment analysis of targets were based on R language.Results:Four main chemical components including quercetin,wogonin,fisetin and kaempferol were screened,and four key targets including ESR1、NOS2、PGR and CHRM3 were identified.In GO enrichment analysis,66 molecular function entries,1040 biological process entries,26 cell component entries were obtained.KEGG pathway enrichment analysis showed that zhitong rushen decoction played a therapeutic role in functional anorectal pain by regulating AGE-RAGE signaling pathway in diabetic complications,Bladder cancer,Estrogen signaling pathway,HIF-1 signaling pathway.Conclusion:Zhitong rushen decoction for the treatment of functional anorectal pain may be related to its multi-component effect on multiple targets and multiple signaling pathways,providing theoretical basis for further study of active ingredients and mechanism of action.展开更多
AIM To find the association between asthma and different types of functional abdominal pain disorders(FAPDs) among teenagers. METHOD A cross-sectional study was conducted among 13 to 15-year-old children from six rand...AIM To find the association between asthma and different types of functional abdominal pain disorders(FAPDs) among teenagers. METHOD A cross-sectional study was conducted among 13 to 15-year-old children from six randomly selected schools in Anuradhapura district of Sri Lanka. Data were collected using translated and validated selfadministered questionnaires(Rome Ⅲ questionnaire, International Study on Asthma and Allergies in Childhood questionnaire, and Pediatric Quality of Life Inventory 4.0) and administered under an examination setting after obtaining parental consent and assent.RESULTS Of the 1101 children included in the analysis, 157(14.3%) had asthma and 101(9.2%) had at least one FAPDs. Of children with asthma, 19.1% had at least one type of FAPDs. Prevalence rates of functional abdominal pain(FAP)(8.9% vs 3.3% in nonasthmatics), functional dyspepsia(FD)(2.5% vs 0.7%), and abdominal migraine(AM)(3.2% vs 0.4%) were higher in those with asthma(P < 0.05, multiple logistic regression analysis), but not in those with irritable bowel syndrome(4.5% vs 3.1%, P = 0.2). Severe abdominal pain(10.8% vs 4.6%), bloating(16.6% vs 9.6%), nausea(6.4% vs 2.9%), and anorexia(24.2% vs 16.2%) were more prevalent among asthmatics(P < 0.05). Lower gastrointestinal symptoms did not show a significant difference. Scores obtained for health related quality of life(HRQoL) were lower in those with asthma and FAPDs(P < 0.05, unpaired t-test).CONCLUSION Asthma is associated with three different types of FAPDs, namely, FD, AM, and FAP. HRQoL is significantly impaired in teenagers with asthma and FAPDs.展开更多
AIM:To investigate the efficacy of amitriptyline with proton pump inhibitor(PPI)for the treatment of functional chest pain(FCP).METHODS:This was a randomized,open-label trial investigating the addition of low dose ami...AIM:To investigate the efficacy of amitriptyline with proton pump inhibitor(PPI)for the treatment of functional chest pain(FCP).METHODS:This was a randomized,open-label trial investigating the addition of low dose amitriptyline(10 mg at bedtime)to a conventional dose of rabeprazole(20 mg/d)(group A,n = 20)vs a double-dose of rabeprazole(20 mg twice daily)(group B,n = 20)for patients with FCP whose symptoms were refractory to PPI.The primary efficacy endpoints were assessed by global symptom score assessment and the total number of individuals with > 50% improvement in their symptom score.RESULTS:The between-group difference in global symptom scores was statistically significant during the last week of treatment(overall mean difference;3.75 ± 0.31 vs 4.35 ± 0.29,the between-group difference;P < 0.001).Furthermore,70.6% of patients in group A had their symptoms improve by > 50%,whereas only 26.3% of patients in group B had a similar treatment response(70.6% vs 26.3%,P = 0.008).Specifically,patients in group A had a significantly greater improvement in the domains of body pain and general health perception than did patients in group B(52.37 ± 17.00 vs 41.32 ± 12.34,P = 0.031 and 47.95 ± 18.58 vs 31.84 ± 16.84,P = 0.01,respectively).CONCLUSION:Adding amitriptyline to a PPI was more effective than a double-dose of PPI in patients with FCP refractory to a conventional dose of PPI.展开更多
OBJECTIVE: To investigate clinical effect of acupuncture combined with TCM fumigation on pain and active function improvement in patients with ankylosing spondylitis. METHODS: 42 patients with ankylosing spondylitis w...OBJECTIVE: To investigate clinical effect of acupuncture combined with TCM fumigation on pain and active function improvement in patients with ankylosing spondylitis. METHODS: 42 patients with ankylosing spondylitis were selected in hospital from October 2016 to October 2017, who were randomly divided into 2 groups by number table method. 21 patients received conventional treatment as control group. 21 patients combined with acupuncture, TCM fumigation treatment as observation group. Clinical indicators, activity function, pain scores were evaluated before and after treatment. RESULTS: Erythrocyte sedimentation rate, C reactive protein, alkaline phosphatase, macrophage migration inhibitory factor, BASDAI score, BASFI score, VAS score after treatment decreased in two groups compared with before treatment(P<0.05). Chest mobility, lumbar pitch, Schober test, occipital wall distance, lumbar lateral flexion after treatment increased in two groups compared with before treatment(P<0.05). Refers to distance, morning stiffness time, rump length after treatment reduced in two groups compared with before treatment(P<0.05). Erythrocyte sedimentation rate, C reactive protein, alkaline phosphatase, macrophage migration inhibitory factor, BASDAI score, BASFI score, VAS score in observation group were lower than control group after treatment(P<0.05). Chest mobility, lumbar pitch, Schober test, occipital wall distance, lumbar lateral flexion in observation group were higher than control group after treatment(P<0.05). Refers to distance, rump length in observation group were smaller than control group after treatment(P<0.05). Morning stiffness time in observation group was less than control group after treatment(P<0.05). CONCLUSIONS: Acupuncture combined with TCM fumigation can significantly improve pain and active function in patients with ankylosing spondylitis, which is worthy of clinical promotion.展开更多
Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain p...Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of vaded acupunctures were compared using resting-state functional MRI. Patients from both groups received functional MRI before and after acupuncture. Functional connectivity in brain regions that were strongly associated with the bilatera amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endogenous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.展开更多
基金Supported by The University of Kelaniya,Sri Lanka,Research Council Grant No.G23.
文摘BACKGROUND Overweight children exhibit a higher prevalence of functional gastrointestinal disorders compared with their normal-weight peers,yet the underlying reasons remain unclear.Gastrointestinal motility,a key pathophysiological factor in functional gastrointestinal disorders,may be influenced by body mass index(BMI).AIM To evaluate the impact of BMI on gastric motility parameters in children with functional abdominal pain disorders(FAPDs).METHODS We assessed gastric motility in 176 children with FAPDs(61.4%females,mean age 7.94 years,SD 1.96 years)and 63 healthy controls(57.1%females,mean age 9.17 years,SD 1.90 years)at the Gastroenterology Research Laboratory,University of Kelaniya,Sri Lanka.FAPDs were diagnosed and subtyped using the Rome IV criteria:Functional abdominal pain 97 patients;irritable bowel syndrome 39 patients,functional dyspepsia(FD)25 patients;and abdominal migraine 15 patients.Gastric motility was measured using a validated ultrasound method.Weight and height were measured using sensitive standard scales.RESULTS The BMIs of children with FAPDs and controls were 15.04 and 15.46 kg/m^(2),respectively(P=0.33).Fasting antral area(FAA)and antral area at 1 min(AA1)and 15 min(AA15)were significantly greater in patients with FAPD with a higher BMI(2.71 cm^(2),12.57 cm^(2),and 7.19 cm^(2),respectively)compared with those with a lower BMI(2.12 cm^(2),10.68 cm^(2),and 6.13 cm^(2),respectively)(P<0.01).BMI positively correlated with FAA and AA15(r=0.18 and r=0.19,respectively)(P<0.01)in those with FAPDs.In controls,only AA1 was greater in the higher BMI group(12.51 cm^(2)vs 9.93 cm^(2))and had a positive correlation(r=0.33)(P≤0.01).Subgroup analysis revealed that in patients with FD,BMI negatively correlated with gastric emptying rate(GER)(r=-0.59)and antral motility index(MI)(r=-0.49),while in functional abdominal pain,MI positively correlated(r=0.25)with BMI(P≤0.01).CONCLUSION In children with FAPDs,higher BMI was associated with increased gastric antral distention during fasting and postprandial periods(as indicated by FAA,AA1,and AA15)but not with contractility and transit(MI,GER).However,in the FD subgroup,high BMI correlated with reduced GER and MI.This indicates the possible role of BMI in gastric hypomotility and the pathophysiology of FD.These findings underscore the importance of lifestyle and dietary interventions aimed at optimizing BMI in the management of FAPDs,particularly FD.
文摘Objective To explore the clinical effects of heat-sensitizing moxibustion on functional anorectal pain. Methods Thirty six patients with functional anorectal pain were treated with moxibustion on heat-sensitive acupuncture points.The heat-sensitized points include Chángqiáng（长强 GV l）, Cìliáo（次髎 BL 32）, Yāoshū（腰俞 GV 2）, and local perianal points. A course of treatment consisted of treatment at each heat-sensitized point for 15 min once per day for 10 days. The therapeutic effects were observed after continuous treatment for 3 treatment cycles. Results Twelve cases were cured, eleven cases had effective results, and 3 cases were ineffective. The total effectiveness rate was 91.7%. The visual analog scale（VAS） total score was 6.1±1.52 before treatment and was 1.63±1.05 after treatment, showing a statistically significant difference（P〈0.01）. Conclusion Heat-sensitization moxibustion can significantly relieve functional anorectal pain.
基金Supported by Innovation and Application Project,Chongqing Bureau of Science and Technology:cstc2019jscx-msxmX02292019"Xinglin Scholar"Project of Chongqing TCM Hospital affiliated to Chengdu University of Traditional Chinese Medicine:YYZX2019080Chongqing famous senior TCM expert Xu Yue inheritance studio。
文摘Objective:To investigate the clinical effect of electroacupuncture combined with biofeedback on functional anorectal pain.Methods:Sixty patients diagnosed functional anorectal pain were divided into three groups by random number table,namely electroacupuncture group,biofeedback group,and combination group,with 20 patients in each.In the electroacupuncture group,the electroacupuncture at Dong’s points Sānqí(三其穴),including Qímén(其门),Qíjiǎo(其角),and Qízhéng(其正),and Línggǔ(灵骨),Dàbái(大白),Chángmén(肠门)of both sides was given;in the Biofeedback group,the biofeedback therapy was adopted;in the combination group,the electroacupuncture and biofeedback therapy were used.All patients were treated once a day,30 min each time,10 consecutive treatments as one treatment course,and the therapeutic effect was evaluated after 3 treatment courses.The observation indexes after the intervention:Visual analogue Scale(VAS)score,SF-36 Quality of Life Scale score,Self-rating Anxiety Scale(SAS)score,Self-rating Depression Scale(SDS)score,Anorectal manometry,Clinical efficacy,and patients’adverse reactions.Results:After treatment,the pain of patients in the three groups was alleviated than that before treatment,VAS score,SAS score,SDS score,and anorectal pressure were decreased(P<0.05),and SF-36 Quality of Life Scale score was increased(P<0.05).After treatment,in the combination group,the VAS scores,SAS scores,SDS scores,and Anal-rectal pressure scores were lower than those in the other two groups(P<0.05),and SF-36 Quality of Life Scale scores were higher than those in the other two groups(P<0.05),the total effective rate was 80.0%(16/20),which was significantly higher than that of the electroacupuncture group(55.0%,11/20)and the biofeedback group(40.0%,8/20)(both P<0.05).No adverse reactions occurred in all three groups.Conclusion:Electroacupuncture at Dong’s points combined with biofeedback therapy has a significant effect on functional anorectal pain.The combined application of electroacupuncture and biofeedback therapy has a synergic action,and the analgesic effect is better than that of only using electroacupuncture or biofeedback therapy.
基金funded by the Priority Academic Program Development of Jiangsu Higher Education Institution(Grant No.2014-37)the Jiangsu Provincial Health and Family Planning Commission(No.H201535)Orofacial Pain and TMD Research Unit,Institute of Stomatology,Affiliated Hospital of Stomatology,Nanjing Medical University,for their support
文摘Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodontic treatment. Forty individuals(12–33 years old; mean ± standard deviations: 20.8 ± 5.9 years) scheduled to receive orthodontic treatment were randomly divided into a laser group(LG) or a placebo group(PG)(1:1). The LG received LLLT(810-nm gallium-aluminium-arsenic diode laser in continuous mode with the power set at 400 mW, 2 J·cm–2) at 0 h, 2 h, 24 h, 4 d, and 7 d after treatment, and the PG received inactive treatment at the same time points. In both groups, the non-treated side served as a control. A numerical rating scale(NRS) of pain, pressure pain thresholds(PPTs), cold detection thresholds(CDTs), warmth detection thresholds(WDTs), cold pain thresholds(CPTs), and heat pain thresholds(HPTs) were tested on both sides at the gingiva and canine tooth and on the hand. The data were analysed by a repeated measures analysis of variance(ANOVA). The NRS pain scores were significantly lower in the LG group(P = 0.01). The CDTs,CPTs, WDTs, HPTs, and PPTs at the gingiva and the PPTs at the canine tooth were significantly less sensitive on the treatment side of the LG compared with that of the PG(P < 0.033). The parameters tested also showed significantly less sensitivity on the nontreatment side of the LG compared to that of the PG(P < 0.043). There were no differences between the groups for any quantitative sensory testing(QST) measures of the hand. The application of LLLT appears to reduce the pain and sensitivity of the tooth and gingiva associated with orthodontic treatment and may have contralateral effects within the trigeminal system but no generalized QST effects. Thus, the present study indicated a significant analgesia effect of LLLT application during orthodontic treatment.Further clinical applications are suggested.
基金a Research Grant from the University of Kelaniya,Sri Lanka,No.RP/03/04/03/01/2013
文摘BACKGROUND Abdominal pain-predominant functional gastrointestinal disorders(AP-FGIDs)are the most common cause of recurrent abdominal pain in children. Despite its high prevalence, the underlying pathophysiology of this condition is poorly understood.AIM To assess the role of gastric dysmotility and autonomic nervous system dysfunction in the pathophysiology of AP-FGIDs.METHODS One hundred children, fulfilling Rome III criteria for AP-FGIDs, and 50 healthy controls, aged 5 to 12 years, were recruited after obtaining parental consent. All patients were investigated for underlying organic disorders. Gastric motility and cardiovascular autonomic functions were assessed using validated non-invasive techniques.RESULTS The main gastric motility parameters assessed(gastric emptying rate [45.7 vs 59.6 in controls], amplitude [48.7 vs 58.2], frequency of antral contractions [8.3 vs 9.4],and antral motility index [4.1 vs 6.4]) were significantly lower in children with AP-FGIDs(P < 0.05). The post-prandial antral dilatation at 1 min after the test meal significantly correlated with the severity of abdominal pain(P < 0.05).Assessment of autonomic functions in AP-FGID patients showed neither a significant difference compared to the control group, nor a correlation with gastric motility abnormalities(P > 0.05). The duration of pain episodes negatively correlated with the parasympathetic tone(maladaptive parasympathetic tone)(P< 0.05).CONCLUSION Children with AP-FGIDs have abnormal gastric motility but normal cardiovascular autonomic functions. There is no relationship between abnormal gastric motility and autonomic functions. The pathogenesis of AP-FGIDs is not related to cardiovascular autonomic dysfunction.
文摘AIM:To assess the efficacy of glucomannan(GNN) as the sole treatment for abdominal pain-related functional gastrointestinal disorders(FGIDs).METHODS:We conducted a double-blind,placebocontrolled,randomized trial.Patients were recruited among children referred to the Department of Paediatrics,Medical University of Warsaw.Included in the study were children aged 7-17 years with abdominal pain-related FGIDs classified according to the Rome Ⅲ diagnostic criteria.The children were randomly assigned to receive GNN,a polysaccharide of 1,4-D-glucose and D-mannose,a soluble fiber from the Japanese Konjac plant,at a dosage of 2.52 g/d(1 sachet of 1.26 g 2 times a day),or a comparable placebo(maltodextrin) at the same dosage.The content of each sachet was dissolved in approximately 125 mL of fluid and was consumed twice daily for 4 wk.RESULTS:Of the 89 eligible children,84(94%) completed the study."No pain" and "treatment success"(defined as no pain or a decrease ≥ 2/6 points on the FACES Pain Scale Revised) were similar in the GNN(n = 41) and placebo(n = 43) groups [no pain(12/41 vs 6/43,respectively;RR = 2.1,95%CI:0.87-5.07) as well as treatment success(23/41 vs 20/43;RR = 1.2,95%CI:0.79-1.83)].No significant differences between the groups were observed in the secondary outcomes,such as abdominal cramps,abdominal bloating/gassiness,episodes of nausea or vomiting,or a changed in stool consistency.GNN demonstrated no significant influence on the number of children requiring rescue therapy,school absenteeism,or daily activities.CONCLUSION:In our setting,GNN,as dosed in this study,was no more effective than the placebo in achieving therapeutic success in the management of FGIDs in children.
基金NIH grants R01 HD36069-06 awarded to Dr.Levy and R24 067674 awarded to Dr.Whitehead
文摘This paper reviews empirical work on cognitive and social learning contributions to the etiology and treatment of illness behavior associated with functional abdominal pain and inflammatory bowel disease. A particular emphasis is placed on randomized controlled trials, the majority of which are multi-modal in orientation, incorporating elements of cognitive behavioral therapy, social learning, and relaxation. Based on this review, we offer methodological and clinical suggestions: (1) Research investigations should include adequate sample sizes, long-term follow-up assessments, and a credible, active control group. (2) Standard gastrointestinal practice should include, when appropriate, learning opportunities for patients and family members, for example, instruction regarding the encouragement of wellness behavior.
文摘Background: The aim of this study was to assess the effects of functional training (FT) on pain, function, and performance in elite male taekwondo players with CMLBP. Method: 27 elite male taekwondo players (mean ± standard deviation: age 24.4 ± 4.9 years, body mass 75.7 ± 15.1 kg, height 181.4 ± 7.8 cm) were allocated to two experimental (n = 15) and control (n = 12) groups. The eight-week FT was divided into four distinct phases for the subjects of the experimental group. Variables of pain and function were assessed by Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), respectively. The movement time of Ap Douliou Chagi kick (MTAK) and speed of Ap Douliou Chagi kick (SAK) was used for the variable of performance. Results: Considering the results of pretest before the implementation of the scores protocol, after FT intervention, VAS (p = 0.004), ODI (p = 0.005), MTAK on the right leg (p = 0.029) and the left leg (p = 0.013) decreased and SAK on both legs (p = 0.000) increased significantly in comparison with the control group. Conclusion: It is assumed that FT can reduce the pain intensity and improve the function and performance in taekwondo players.
文摘Functional abdominal pain disorders(FAPDs) are an important and prevalent cause of functional gastrointestinal disorders among children, encompassing the diagnoses of functional dyspepsia, irritable bowel syndrome, abdominal migraine, and the one not previously present in Rome Ⅲ, functional abdominal pain not otherwise specified. In the absence of sufficiently effective and safe pharmacological treatments for this public problem, non-pharmacological therapies emerge as a viable means of treating these patients, avoiding not only possible side effects, but also unnecessary prescription, since many of the pharmacological treatments prescribed do not have good efficacy when compared to placebo. Thus, the present study provides a review of current and relevant evidence on non-pharmacological management of FAPDs, covering the most commonly indicated treatments, from cognitive behavioral therapy to meditation, acupuncture, yoga, massage, spinal manipulation, moxibustion, and physical activities. In addition, this article also analyzes the quality of publications in the area, assessing whether it is possible to state if non-pharmacological therapies are viable, safe, and sufficiently well-based for an appropriate and effective prescription of these treatments. Finally, it is possible to observe an increase not only in the number of publications on the non-pharmacological treatments for FAPDs in recent years, but also an increase in the quality of these publications. Finally, the sample selection of satisfactory age groups in these studies enables the formulation of specific guidelines for this age group, thus avoiding the need for adaptation of prescriptions initially made for adults, but for children use.
文摘Objective： To observe the clinical efficacy of oral traditional Chinese medicine （Jiaweitiaoqi decoction）, electroacupuncture, biofeedback, and combined treatment on functional anorectal pain （FAP）. Methods： A total of 200 patients with FAP were randomly divided into 4 groups, with 50 patients in each group. Group 1 was given oral Jiaweitiaoqi decoction; group 2 was given electroacupuncture at the lumbosacral acupoints; group 3 was given biofeedback training; and group 4 was given combined treatment. The numeric rating scale （NRS）, Short Form-36 （SF-36） quality of life scale, static pressure of the anal canal, and maximum systolic pressure were observed in the 4 groups. Results： The observation indices of the 4 groups were all improved after treatment compared with those before treatment, and the fourth group showed the most obvious improvement. Regarding NRS scores, the static pressure of the anal canal, and maximum systolic pressure, group 4 had lower values than the other 3 groups （P 〈 0.05 for all）. In the SF-36 quality of life score, group 4 showed a higher value than the other 3 groups （P 〈 0.05）. Conclusion： Non-drug therapy including acupuncture and physical exercise can enhance the clinical efficacy of single Chinese medicine in the treatment of FAP .
文摘AIM: To validate the culturally-adapted Persian Functional Rating Index(PFRI) for assessing neck pain(NP) in athletes. METHODS: In this cross-sectional study, 100 athletes with NP and 50 healthy athletes participated and responded to the PFRI. Fifty athletes with NP completed the PFRI for at least 7 d later to establish test-retest reliability. RESULTS: The athletes with NP responded to all items, indicating excellent clinical utility. No floor and ceiling effects were found, indicating content validity and responsiveness. The PFRI revealed capability to discriminate between the athletes with NP and healthy athletes. The PFRI demonstrated strong correlation with the Numerical Rating Scale(Spearman's rho = 0.94), and the Persian Neck Disability Index(Pearson r = 0.995), supporting criterion and construct validity. Internal consistency reliability was high(Cronbach's α coefficient: 0.97). The test-retest reliability was excellent(ICCagreement = 0.96). The absolute reliability values of standard error of measurement and smallest detectable change were 3.2 and 8.84, respectively. An exploratory factor analysis yielded one factor explaining 78.03% of the total variance. CONCLUSION: The PFRI is a valid and reliable measure of functional status in athletes with NP.
基金Supported by National Natural Science Foundation of China(No.81660158 No.81400372)+1 种基金Natural Science Key Project of Jiangxi Province(No.20161ACB21017)Health Development Planning Commission Science Foundation of Jiangxi Province(No.20175116)
文摘AIM: To study the changes of the resting state functional connectivity(rsFC) between acute eye pain(EP) subjects and healthy controls(HCs) in the two hemispheres by using voxel-mirrored homotopic connectivity(VMHC) method.METHODS: Totally 20 patients with EP and 20 HCs were enrolled, sex, age, and education were matched, and all subjects were examined by functional magnetic resonance imaging(fMRI) scans at resting-state. The changes of rs FC between the hemispheres were evaluated by the VMHC method according to Gaussian random field(GRF) theory. In order to identify the VMHC, as biomarkers for distinguishing EP and from HC, the receiver operating characteristic curves(ROC) had been analyzed. The relationships were evaluated with Pearson correlation analysis between the mean VMHC signal values and clinical features in these patients.RESULTS: By comparing with health subjects, the significant decreased VMHC values was observed in lingual/calcarine(Brodmann area, BA 30), precentral/postcentral gyrus(PreCG/PosCG; BA 4) and medial frontal gyrus(MFG; BA 8)(false discovery rate corrected <0.01) in the acute EP individuals. The accuracy of area under curve was excellent indicated by the ROC curve analysis of each brain regions.CONCLUSION: Our study demonstrates preliminary evidence of disrupted interhemispheric rsFC in acute EP in sensorimotor and limbic system and somatosensory cortex, which might give some useful information for understanding the neurological mechanisms in acute EP individuals.
文摘Functional pain syndromes are very common diseases that negatively impact the quality of life of patients with important socio-economic repercussions. The clinical alterations associated with these pathologies are multiple and have a complex psycho-organic character that moves along the micorobiome-gut-brain-axis. For the present study, 45 patients of both sexes (19 male, 26 female) aged 30 - 59 years were enrolled because of a diagnosis of Functional pain syndromes (FPS) that lasted for more than 6 months. All patients underwent pre-treatment clinical assessments (T0) for anxiety disorder, multidimensional assessment of pain, monitoring of baseline values of Alpha-Theta cerebral rhythm in occipital region and monitoring of salivary cortisol levels. All the patients underwent a clinical treatment combined with central neuromodulation with neurofeedback—Alpha Theta increase protocols (once a week for three months), administration of multispecies probiotic (one dose per day for 3 months) and clinical psychological interviews (once a week for three months). At the end of treatment (T1), patients were re-evaluated. Results show statistically relevant improvements of each feature considered: the Relief from Pain provided by the medication increases on average from 36.6% to 87.3%, the salivary Cortisol level at 11 pm decreases from 6.4 ng/ml to a physiological value of 1.2 ng/ml, and the anxiety rating score is reduced from 28 to 12. Moreover, the 23.9% increase in α-θ relative power shows the positive outcome of the brain autoregulation. This study highlights that the combined approach of Neurofeedback with drugs and multispecies probiotic results in great improvements in the patients’ life.
基金The 13th Five-Year plan for Nanjing famous traditional Chinese medicine studio construction project(No.ZXP-2019-NJ)Nanjing medical science and technology development project(No.YKK18137)
文摘Objective:Network pharmacology method was adopted in this study to screen the target of Zhitong Rushen Decoction of the treatment to Functional Anorectal Pain(FAP)and explore its mechanism of treatment.Methods:Chemical components and selected targets related to the ten traditional Chinese medicine(TCM)herbs were searched through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).Through GeneCards database,OMIM database,disease targets of FAP were searched.R language was used to screen the common targets between drugs and disease,and then the interaction network diagram of the targets was constructed by String.Cytoscape3.7.0 was applied to construct the active ingredients-targets interacted network.GO enrichment analysis and KEGG enrichment analysis of targets were based on R language.Results:Four main chemical components including quercetin,wogonin,fisetin and kaempferol were screened,and four key targets including ESR1、NOS2、PGR and CHRM3 were identified.In GO enrichment analysis,66 molecular function entries,1040 biological process entries,26 cell component entries were obtained.KEGG pathway enrichment analysis showed that zhitong rushen decoction played a therapeutic role in functional anorectal pain by regulating AGE-RAGE signaling pathway in diabetic complications,Bladder cancer,Estrogen signaling pathway,HIF-1 signaling pathway.Conclusion:Zhitong rushen decoction for the treatment of functional anorectal pain may be related to its multi-component effect on multiple targets and multiple signaling pathways,providing theoretical basis for further study of active ingredients and mechanism of action.
文摘AIM To find the association between asthma and different types of functional abdominal pain disorders(FAPDs) among teenagers. METHOD A cross-sectional study was conducted among 13 to 15-year-old children from six randomly selected schools in Anuradhapura district of Sri Lanka. Data were collected using translated and validated selfadministered questionnaires(Rome Ⅲ questionnaire, International Study on Asthma and Allergies in Childhood questionnaire, and Pediatric Quality of Life Inventory 4.0) and administered under an examination setting after obtaining parental consent and assent.RESULTS Of the 1101 children included in the analysis, 157(14.3%) had asthma and 101(9.2%) had at least one FAPDs. Of children with asthma, 19.1% had at least one type of FAPDs. Prevalence rates of functional abdominal pain(FAP)(8.9% vs 3.3% in nonasthmatics), functional dyspepsia(FD)(2.5% vs 0.7%), and abdominal migraine(AM)(3.2% vs 0.4%) were higher in those with asthma(P < 0.05, multiple logistic regression analysis), but not in those with irritable bowel syndrome(4.5% vs 3.1%, P = 0.2). Severe abdominal pain(10.8% vs 4.6%), bloating(16.6% vs 9.6%), nausea(6.4% vs 2.9%), and anorexia(24.2% vs 16.2%) were more prevalent among asthmatics(P < 0.05). Lower gastrointestinal symptoms did not show a significant difference. Scores obtained for health related quality of life(HRQoL) were lower in those with asthma and FAPDs(P < 0.05, unpaired t-test).CONCLUSION Asthma is associated with three different types of FAPDs, namely, FD, AM, and FAP. HRQoL is significantly impaired in teenagers with asthma and FAPDs.
文摘AIM:To investigate the efficacy of amitriptyline with proton pump inhibitor(PPI)for the treatment of functional chest pain(FCP).METHODS:This was a randomized,open-label trial investigating the addition of low dose amitriptyline(10 mg at bedtime)to a conventional dose of rabeprazole(20 mg/d)(group A,n = 20)vs a double-dose of rabeprazole(20 mg twice daily)(group B,n = 20)for patients with FCP whose symptoms were refractory to PPI.The primary efficacy endpoints were assessed by global symptom score assessment and the total number of individuals with > 50% improvement in their symptom score.RESULTS:The between-group difference in global symptom scores was statistically significant during the last week of treatment(overall mean difference;3.75 ± 0.31 vs 4.35 ± 0.29,the between-group difference;P < 0.001).Furthermore,70.6% of patients in group A had their symptoms improve by > 50%,whereas only 26.3% of patients in group B had a similar treatment response(70.6% vs 26.3%,P = 0.008).Specifically,patients in group A had a significantly greater improvement in the domains of body pain and general health perception than did patients in group B(52.37 ± 17.00 vs 41.32 ± 12.34,P = 0.031 and 47.95 ± 18.58 vs 31.84 ± 16.84,P = 0.01,respectively).CONCLUSION:Adding amitriptyline to a PPI was more effective than a double-dose of PPI in patients with FCP refractory to a conventional dose of PPI.
文摘OBJECTIVE: To investigate clinical effect of acupuncture combined with TCM fumigation on pain and active function improvement in patients with ankylosing spondylitis. METHODS: 42 patients with ankylosing spondylitis were selected in hospital from October 2016 to October 2017, who were randomly divided into 2 groups by number table method. 21 patients received conventional treatment as control group. 21 patients combined with acupuncture, TCM fumigation treatment as observation group. Clinical indicators, activity function, pain scores were evaluated before and after treatment. RESULTS: Erythrocyte sedimentation rate, C reactive protein, alkaline phosphatase, macrophage migration inhibitory factor, BASDAI score, BASFI score, VAS score after treatment decreased in two groups compared with before treatment(P<0.05). Chest mobility, lumbar pitch, Schober test, occipital wall distance, lumbar lateral flexion after treatment increased in two groups compared with before treatment(P<0.05). Refers to distance, morning stiffness time, rump length after treatment reduced in two groups compared with before treatment(P<0.05). Erythrocyte sedimentation rate, C reactive protein, alkaline phosphatase, macrophage migration inhibitory factor, BASDAI score, BASFI score, VAS score in observation group were lower than control group after treatment(P<0.05). Chest mobility, lumbar pitch, Schober test, occipital wall distance, lumbar lateral flexion in observation group were higher than control group after treatment(P<0.05). Refers to distance, rump length in observation group were smaller than control group after treatment(P<0.05). Morning stiffness time in observation group was less than control group after treatment(P<0.05). CONCLUSIONS: Acupuncture combined with TCM fumigation can significantly improve pain and active function in patients with ankylosing spondylitis, which is worthy of clinical promotion.
基金funded by the Scientific Research Innovation Program regarding Traditional Chinese Medicine of Guangzhou University of Chinese Medicine (Central mechanism of balanced acupuncture for lumbar disc herniationusing functional MRI), No. 09CX068
文摘Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of vaded acupunctures were compared using resting-state functional MRI. Patients from both groups received functional MRI before and after acupuncture. Functional connectivity in brain regions that were strongly associated with the bilatera amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endogenous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.
